Active NPI
Angel Charissa Evans, LICENSE SOCIAL WORK
- Social Worker
- Arroyo Grande, CA
National Provider Identifier
1881257608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S30473
- Practice address
- 345 S Halcyon Rd
Arroyo Grande, CA 93420-3817 - Phone
- (805) 489-4261
- NPI assigned
- Apr 17, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S30473 | OH | Primary |
Addresses
Primary practice location
345 S Halcyon Rd
Arroyo Grande, CA 93420-3817
Mailing address
11505 Parkview Ave
Cleveland, OH 44104-5053
Phone (216) 834-3857
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S30473 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555459200000",
"number": "1881257608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11505 PARKVIEW AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441045053",
"telephone_number": "216-834-3857"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "345 S HALCYON RD",
"city": "ARROYO GRANDE",
"state": "CA",
"postal_code": "934203817",
"telephone_number": "805-489-4261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "ANGEL",
"middle_name": "CHARISSA",
"credential": "LICENSE SOCIAL WORK",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-17",
"last_updated": "2019-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S30473",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arroyo Grande, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.